ABSTRACT
Acute limb ischemia (ALI) due to an embolism is associated with high mortality rate and poor prognosis, and early diagnosis with prompt revascularization is required to reduce the risk of limb amputation or even death. The etiologies of ALI are diverse, and it includes an embolism from the heart and thrombotic occlusion of the atherosclerotic native vessels, stents, or grafts. An uncommon cause of ALI is acute arterial thromboembolism, and atrial fibrillation (AF) is the single most important risk factors for systemic thromboembolism. It is important to correctly identify the source of ALI for secondary prevention, as it depends on the underlying cause. Percutaneous transluminal angioplasty (PTA) has been proven to be a safe and effective treatment for focal atherosclerotic and thrombotic occlusive diseases of the aorta and its major extremity branches. Herein, we report on a 77-year-old female patient with acute upper limb ischemia, treated by PTA using a catheter-guided thrombectomy. He was newly diagnosed with paroxysmal AF (PAF) while evaluation the cause of his acute arterial thromboembolism. We recommend that cardiologists always consider PAF as a possible diagnosis even in patients without any history of AF under ALI because it is possible to develop thromboembolism in clinical practice.
Subject(s)
Aged , Female , Humans , Amputation, Surgical , Angioplasty , Aorta , Atrial Fibrillation , Diagnosis , Early Diagnosis , Embolism , Extremities , Heart , Ischemia , Mortality , Peripheral Arterial Disease , Prognosis , Risk Factors , Secondary Prevention , Stents , Thrombectomy , Thromboembolism , Transplants , Upper ExtremityABSTRACT
Mirizzi syndrome is a rare complication, resulting in bile duct obstruction and jaundice that usually arise from impacted gallstone in the cystic duct or neck of the gallbladder. It is vitally important to confirm underlying cystic duct anomaly in Mirizzi syndrome since it can produce surgical difficulty and higher complications. Generally, Mirizzi syndrome is treated surgically while endoscopic treatment is limited. Herein, we present Mirizzi syndrome with low lying cystic duct and remnant cyst duct calculi treated successfully by biliary stent and administration of choleretic agent, following by balloon dilatation on cystic duct and balloon extraction of the stone.
Subject(s)
Humans , Calculi , Cholangiopancreatography, Endoscopic Retrograde , Cholangitis , Cholestasis , Cystic Duct , Deception , Dilatation , Gallbladder , Gallstones , Jaundice , Mirizzi Syndrome , Neck , StentsABSTRACT
Mirizzi syndrome is a rare complication, resulting in bile duct obstruction and jaundice that usually arise from impacted gallstone in the cystic duct or neck of the gallbladder. It is vitally important to confirm underlying cystic duct anomaly in Mirizzi syndrome since it can produce surgical difficulty and higher complications. Generally, Mirizzi syndrome is treated surgically while endoscopic treatment is limited. Herein, we present Mirizzi syndrome with low lying cystic duct and remnant cyst duct calculi treated successfully by biliary stent and administration of choleretic agent, following by balloon dilatation on cystic duct and balloon extraction of the stone.
Subject(s)
Humans , Calculi , Cholangiopancreatography, Endoscopic Retrograde , Cholangitis , Cholestasis , Cystic Duct , Deception , Dilatation , Gallbladder , Gallstones , Jaundice , Mirizzi Syndrome , Neck , StentsABSTRACT
Acute limb ischemia (ALI) due to an embolism is associated with high mortality rate and poor prognosis, and early diagnosis with prompt revascularization is required to reduce the risk of limb amputation or even death. The etiologies of ALI are diverse, and it includes an embolism from the heart and thrombotic occlusion of the atherosclerotic native vessels, stents, or grafts. An uncommon cause of ALI is acute arterial thromboembolism, and atrial fibrillation (AF) is the single most important risk factors for systemic thromboembolism. It is important to correctly identify the source of ALI for secondary prevention, as it depends on the underlying cause. Percutaneous transluminal angioplasty (PTA) has been proven to be a safe and effective treatment for focal atherosclerotic and thrombotic occlusive diseases of the aorta and its major extremity branches. Herein, we report on a 77-year-old female patient with acute upper limb ischemia, treated by PTA using a catheter-guided thrombectomy. He was newly diagnosed with paroxysmal AF (PAF) while evaluation the cause of his acute arterial thromboembolism. We recommend that cardiologists always consider PAF as a possible diagnosis even in patients without any history of AF under ALI because it is possible to develop thromboembolism in clinical practice.
Subject(s)
Aged , Female , Humans , Amputation, Surgical , Angioplasty , Aorta , Atrial Fibrillation , Diagnosis , Early Diagnosis , Embolism , Extremities , Heart , Ischemia , Mortality , Peripheral Arterial Disease , Prognosis , Risk Factors , Secondary Prevention , Stents , Thrombectomy , Thromboembolism , Transplants , Upper ExtremityABSTRACT
PURPOSE: The study was to determine clinical characteristics of periventricular leukomalacia (PVL) in premature infants and evaluate usefulness of brain MRI as a diagnostic tool in predicting degree of PVL to severity of neurological sequelae at 2 years of age. METHODS: The subjects included twenty premature infants admitted to NICU of Kwangju Christian Hospital from June 1993 to February 1999 whose 2 year follow up was possible. The diagnosis of PVL was made by brain MRI and severity of PVL was divided into 3 grades based on its degree of white matter volume loss. RESULTS: The infants with grade I PVL was 2 (10%), grade II was 14 (70%), grade III was 4 (20%). The mean gestational age was 32.0+/-1.7 weeks and mean birth weight was 1,770+/-370 g. The risk factors associated with PVL were mechanical ventilator care, respiratory distress syndrome, prolonged rupture of membrane, and neonatal seizures. Two patient were diagnosed with PVL later by MRI when increased periventricular echodensity noted on initial neurosonogram improved on subsequent follow up neurosonograms. Accompanied neurological sequelae included motor palsy, language delay, visual impairment, squint and epilepsy. At 2 years of age, infants with grade 1 PVL could walk without support, most (71%) of grade II could crawl and stand holding and most (75%) of grade III could sit with arm support. CONCLUSION: Brain MRI is regarded as a precise tool in diagnosing PVL. The severity of PVL on brain MRI significantly correlated with degree of the motor developmental delay.
Subject(s)
Humans , Infant , Infant, Newborn , Arm , Birth Weight , Brain , Diagnosis , Epilepsy , Follow-Up Studies , Gestational Age , Infant, Premature , Language Development Disorders , Leukomalacia, Periventricular , Magnetic Resonance Imaging , Membranes , Paralysis , Risk Factors , Rupture , Seizures , Strabismus , Ventilators, Mechanical , Vision DisordersABSTRACT
PURPOSE: The study was to determine clinical characteristics of periventricular leukomalacia (PVL) in premature infants and evaluate usefulness of brain MRI as a diagnostic tool in predicting degree of PVL to severity of neurological sequelae at 2 years of age. METHODS: The subjects included twenty premature infants admitted to NICU of Kwangju Christian Hospital from June 1993 to February 1999 whose 2 year follow up was possible. The diagnosis of PVL was made by brain MRI and severity of PVL was divided into 3 grades based on its degree of white matter volume loss. RESULTS: The infants with grade I PVL was 2 (10%), grade II was 14 (70%), grade III was 4 (20%). The mean gestational age was 32.0+/-1.7 weeks and mean birth weight was 1,770+/-370 g. The risk factors associated with PVL were mechanical ventilator care, respiratory distress syndrome, prolonged rupture of membrane, and neonatal seizures. Two patient were diagnosed with PVL later by MRI when increased periventricular echodensity noted on initial neurosonogram improved on subsequent follow up neurosonograms. Accompanied neurological sequelae included motor palsy, language delay, visual impairment, squint and epilepsy. At 2 years of age, infants with grade 1 PVL could walk without support, most (71%) of grade II could crawl and stand holding and most (75%) of grade III could sit with arm support. CONCLUSION: Brain MRI is regarded as a precise tool in diagnosing PVL. The severity of PVL on brain MRI significantly correlated with degree of the motor developmental delay.
Subject(s)
Humans , Infant , Infant, Newborn , Arm , Birth Weight , Brain , Diagnosis , Epilepsy , Follow-Up Studies , Gestational Age , Infant, Premature , Language Development Disorders , Leukomalacia, Periventricular , Magnetic Resonance Imaging , Membranes , Paralysis , Risk Factors , Rupture , Seizures , Strabismus , Ventilators, Mechanical , Vision DisordersABSTRACT
PURPOSE: MMP-2, 72 kDa-type IV collagenase, plays a major role in the migration and growth of tumor cells, a process that requires the disintegration of basement membrane. Activation of MMP-2 is correlated with the invasiveness of various tumors. The aim of this study was to determine the sequence-specific phosphorothioated oligodeoxynucleotides (ODNs) inhibiting the translation of MMP-2 mRNA and the subsequent invasiveness of tumor cells. MATERIALS AND METHODS: Eight types of antisense ODNs were designed and each (8micro gram/ml) were transfected into HT1080 cells. The effects of these antisense ODNs on MMP expression were examined by gelatin zymography, Western blot, Northern blot and matrigel assay. RESULTS: Antisense-5 (+904~923), antisense-6 (+1274~+1293) and antisense-7 (+1646~+1665) reduced the MMP-2 activity of the culture supernatant in HT1080 fibrosarcoma cells. Treatment with antisense-6 showed inhibition of MMP-2 mRNA and protein, and in vitro invasion in a dose-dependent manner. CONCLUSION: Antisense-6 might be one of the therapeutic candidates for tumor invasion and metastasis.